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General NPI Number Information
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NPI Number | 1689052656
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Entity Type | Individual
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Provider Name | JEUNESE FORCHIN FNP
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Gender | Female
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Dates
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Enumeration Date | 05/11/2015
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Last Update Date | 11/11/2022
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Provider Practice Location Address
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Address Line | 3180 N POINT PKWY STE 302
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City | ALPHARETTA
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State | GA
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Zip | 30005-4381
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Country | US
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Telephone | 404-800-5181
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Fax |
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Provider Business Mailing Address
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Address Line | 1411 PINELLA CT
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City | GRAYSON
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State | GA
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Zip | 30017-1185
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Country | US
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Telephone | 847-942-5779
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN272161
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 209012427
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License Number State | IL
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